The last few days or weeks of your pregnancy may seem filled with impatience, anxiety and discomfort. This is a time when doctors and midwives consider a myriad of health factors that could influence a decision to induce labor or to augment non-progressing labor.

If you are hospitalized for induction, your doctor will administer medication to start your labor, in the absence of natural contractions.

‘Augmentation’ is the use of medication to increase the intensity and frequency of contractions that you already have.

We could apply both terms to a single childbirth, for example, if your labor is induced and then slows down because of epidural anesthesia, requiring augmentation.

Labor Induction or Augmentation Requires Informed Consent

If you are a candidate for induction or augmentation, your doctor or nurse will explain known risks, such as the serious side effects of medications or the possible need for additional interventions, anesthesia, or surgical delivery. You may or may not be told that having labor induced or augmented might cause interference with bonding to and breastfeeding your baby.

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What if you were told your baby’s risk of developing autism might be higher as a result of labor induction or augmentation?

That is what the results of a large North Carolina study suggest. Researchers examined the delivery records of over 625,000 babies born between 1990 and 1998, and compared them to findings gleaned from state educational records that were linked to the birth information – and noted an nearly 25% higher rate of autism among kids whose birth was augmented or induced.

Autism Linked to Induction and Augmentation

About one in 88 infants will develop autism, a condition characterized by a lack of imaginative play and impaired social interaction; males outnumber females by about 4 to 1.

According to this study, however, “the risk for developing autism when labor was induced and augmented was found to be 23 per cent higher than for babies of mothers who did not undergo either of those procedures. The risk was independent of other cofactors, including the mother’s age, level of education, number of pregnancies, twin births, fetal distress, preterm delivery and maternal gestational diabetes.”

Induce for Medical Reasons

Chad Grotegut, MD, assistant professor of obstetrics and gynecology at Duke Medicine, and one of the study researchers, told Decoded Pregnancy that “In considering whether to induce a woman, we always weigh the risks of continuing the pregnancy versus the potential maternal or fetal risk of the procedure. Labor induction then has merit when the benefits of proceeding with delivery outweigh the risk of continuing the pregnancy.”

Dr. Grotegut listed preeclampsia, maternal diabetes, poor fetal growth and/or poor placental function as examples of medical indications for inducing labor, stating “in these pregnancies, the risk for stillbirth or poor neonatal outcome if the pregnancy was not induced is much greater than the potential association with autism if the labor was induced.”

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Mary Earhart

A graduate of CSU Domingues Hills BSN program, Mary Earhart is a practicing Licensed Midwife and Public Health Nurse in Southern California. She has worked in hospitals, alternative prison programs, and developed an award-winning ...